Today is the seventh annual World Autism Awareness Day, a day when organizations committed to autism research, advocacy, or policy promote awareness through events and public discussions.

As both a scientist and a father of four – one of whom is an adult child with autism (as well as other mental and physical disabilities) and a second who is actually doing her Ph.D. on the developmental psychology of autism – I am often asked to speak or provide public comment about the autism spectrum conditions, especially their causes.

Indeed, the fact that I lead a multidisciplinary team that develops neglected disease vaccines while also serving as President of the non-profit Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development often places me front and center in the dialogue about purported links between autism and vaccines.

A new paper just published in the New England Journal of Medicine by Eric Courchesne and his colleagues at the University of California, San Diego, confirms that the brains of children with autism have distinct patches of architectural disorganization in their prefrontal and temporal cortical tissue. Because the organization of the cortex begins in the second trimester of pregnancy, Dr. Courchesne concludes that the events leading to the malformation of the cortex must begin around this time or perhaps before then, certainly well before a child is born or ever receives a vaccine.

These new findings make a lot of sense. Another term for autism is pervasive developmental disorder (PDD) and indeed I am often struck by how my child’s neurological deficits are indeed pervasive and that there is no plausible way a vaccine injection could cause such profound structural changes to the brain.

The results of not vaccinating your child can be devastating, such as in a recent measles outbreak in Tarrant County, Texas, and another one in Orange County, Calif., that were both totally preventable. I like to emphasize that measles is not a benign illness, and can cause pneumonia, ear infections, diarrhea and in severe cases, encephalitis.

My research group works closely with the Institute of Health Metrics and Evaluation at the University of Washington Seattle, which recently published findings indicating that worldwide 125,400 children died from measles in 2010, in addition to 81,400 from pertussis, 61,300 from tetanus, and almost one million from pneumococcal disease. We have safe and effective vaccines for each of these diseases and sadly, most of these deaths could have been prevented!

So on this day I hope to continue to educate the public both about our safe and effective vaccines, while focusing national attention on autism where it belongs, namely the urgent need for research on the autism spectrum disorders.

There are some excellent resources for the latest research on autism as and the lack of a correlation between autism and vaccines, as well as for parents to identify autism early, when intervention is most effective.

Here at Baylor College of Medicine and Texas Children’s Hospital there is some extraordinary work going on in our Department of Genetics and at the Jan and Dan Duncan Neurological Research Institute. Our scientists are making extraordinary discoveries leading to the development of new and innovative interventions to combat autism.

As a parent and a vaccine researcher, it is my hope that we put all available resources towards finding the true causes of autism, while also continuing to fully fund the research of new and emerging vaccines that have already saved millions of lives and will save millions more in the next decade. Both issues are critical to our long-term public health and economic prosperity.

Anti-vaccine groups have been speaking out since the late 1980s against the many vaccines recommended for infants and children to prevent childhood infectious diseases. One-third of parents say they are concerned about the safety of vaccines, and one in 10 refuse or delay to vaccinate their children out of those concerns.

One of the most vocal of their worries is that vaccines are linked to autism, and that the standard 28 vaccines recommended for children from birth to age six are excessive and harmful. In fact, some anti-vaccine groups such as Generation Rescue go so far as to claim that autism is a common “side effect” of vaccines.

But in a new study published in the journal Pediatrics, researchers looked at the medical records of 256 children with an autism spectrum disorder (ASD) and 752 typically developing children who received standard vaccines from birth to age two. They wanted to see if the number of “antigens” present in the vaccines, which stimulate the body to produce antibodies to fight infection, had any correlation with the children’s risk of autism. Some anti-vaccine groups believe that the vaccine antigens are too strong for young children’s immune systems, thereby making them more susceptible to autism.

Do Children with ASD Receive more Antigens?

The researchers wanted to see if perhaps children with ASD were receiving more antigens than children without ASD. They evaluated the total antigen numbers in both groups of children by adding the number of different antigens in all vaccines each child received in one day, as well as all vaccines each child received up to 2 years of age. The researchers found that the total antigens from vaccines received by age two, or the maximum number received on a single day, was the same between children with and without ASD.

There is a contention by anti-vaccine groups that because children receive more vaccines than in previous years, they are being exposed to more antigens, and that this is what is causing autism rates to rise. Actually, current vaccines have more targeted antigens, so fewer of the antigens need to be used to be effective now than in previous years. The current vaccine schedule does recommend more vaccines now than in the late 1990s. But the maximum number of antigens by age two in a currently vaccinated child is 315 compared to several thousand in the late 1990s.

The idea that an infant or young child’s immune system is fragile and can’t handle antigens and other “immunologic stimuli,” is simply not true, the authors conclude. Babies are naturally exposed to many viruses and antigens in their everyday world.

“The possibility that immunological stimulation from vaccines during the first one or two years of life could be related to the development of ASD is not well-supported by what is known about the neurobiology of ASDs,” they write.

Tomorrow, October 5, is the first annual Orange Nose Day in celebration of the top five steps to good health:

Wash hands

Get immunized

Eat colorful foods

Exercise

Avoid body fluids

For the autism community this also includes the CDC’s “Learn the Signs. Act Early.” for diagnosing autism and other developmental disabilities early in a child’s life. From birth to 5 years, children should reach certain milestones for playing, learning, speaking and behavior. These milestones are easy ways for parents to know if their child is on course or might need some extra help.

Early diagnosis are critical for children with autism as it allows a child to get the treatments they need. Children with autism in a good early intervention program can make meaningful gains in skills. In fact with early treatment, 30-50% make enough gains to be mainstreamed by kindergarten. Scientists can effectively screen children as early as 12 months [1], and recent studies have even found that some diagnoses can be made as at 6 to 8 weeks [2]. It’s important to note that early intervention programs vary by state, so check with your local organizations.

Beyond early intervention, Orange Nose Day is a reminder for all of us to take a moment and focus on your health. Pledge to take the 5 steps to good health and to wear an orange nose for the day. Our staff will be sporting an orange nosed profile pics on Facebook for the day. You can make your own for free on the Orange Nose Day website.

How will you mark Orange Nose Day with your family? Will you take an extra walk or maybe incorporate a new colorful food into your dinner? Share with us how you’ll be marking this healthy day!

I am thankful, Dr Oz, for the opportunity to participate in your autism show. Both the American Academy of Pediatrics and I hoped the show would help educate the public and move the conversation forward.

As a pediatrician who talks with families everyday in my office, I know parents want to know more about both vaccine safety and about autism. I’m also a mom. Like you, I need accurate information to protect my kids as best as I can.

I am concerned that viewers took away a very inaccurate view of vaccines. The most vocal audience members represent a small minority. Most parents of children with autism agree with the scientific evidence and do not believe that vaccines cause autism.

And, an overwhelming number of healthcare providers worldwide do not believe vaccines and autism are linked. What viewers witnessed on the show was far from the norm.

I base vaccination decisions for my patients and my own children on science, not anecdotes or conspiracy theories. I’m passionate about vaccinations because I watched a child die from chickenpox—a vaccine-preventable illness. I refuse to let another child become a statistic because of hearsay. I’m compassionate towards families whose children have autism, because I have personally walked that road with several patients.

These are the messages that resonate with me, as a parent and a doctor. I hope they will resonate with you.

Multiple studies conducted by academic institutions worldwide—which are not funded by pharmaceutical companies—have shown that vaccines do not play a role in autism. Here are the studies: http://www.aap.org/immunization/families/ingredients.html. Vaccine safety concerns have not been ignored. In fact, they have been addressed appropriately.

Delaying or selectively choosing some vaccinations has absolutely no benefit and only risk. It does not prevent autism, but leaves the youngest children vulnerable to serious infections. The diseases that vaccines protect against can cause disabling health problems or death—and they are often the most severe in younger children. They are not minor illnesses. Here are the diseases preventable by vaccination: http://www.aap.org/immunization/illnesses/illnesses.html

The vaccination schedule recommended by the American Academy of Pediatrics and the Centers for Disease Control has been studied extensively by the most respected group of experts in their field. The time frame provides the safest, most effective way to give certain vaccines together.

While it was not addressed on the show, the combination measles-mumps-rubella (MMR) vaccine and its association to autism have been debunked. The scare began with a report in a British medical journal in 1998 that was recently retracted. Over the past decade, researchers dutifully tried to duplicate the findings of that report and no one ever could. The question was asked, and it was answered.

It’s true—today’s children get more shots than we did as kids. Modern medicine now provides protection against twice as many deadly, disabling diseases. That’s a good thing! For instance, there is now protection against three different forms of bacterial meningitis. Infectious diseases are everywhere. No one can predict when a child will be exposed. And, even in the era of modern medicine—when someone becomes infected with a vaccine-preventable disease, it is usually too late or there is nothing to treat the infection. Prevention is key.

Parents, healthcare providers, and researchers all seek answers for autism spectrum disorders. We will be most successful by working together with the same goal–to discover the true causes of autism.

My advice to parents is to examine the scientific evidence for themselves. Your child’s health is too important to base decisions on inaccurate information. Seek reliable sources for medical information. Go to the AAP website http://www.aap.org/immunization/families/families.html and talk to your child’s doctor. As pediatricians, many of whom are parents too, we vaccinate our own children to protect them. We wouldn’t do anything differently for your child.

Vaccines don’t cause autism-and there was never any proof that they do. Too bad kids had to die while we figured that out.

In 1998, a British surgeon named Andrew Wakefield published a paper claiming that the measles-mumps-rubella (MMR) vaccine might cause autism. To support his case, Dr. Wakefield reported the stories of eight children who had developed symptoms of autism within one month of receiving MMR. He proposed that measles vaccine virus travels to the intestine, causes intestinal damage, and allows for brain-damaging proteins to enter children’s blood streams.

The problem with Dr. Wakefield’s study-published in the Lancet, a leading medical journal-was that it didn’t study the question. To prove his hypothesis, he should have examined the incidence of autism in hundreds of thousands of children who had or hadn’t received MMR. This kind of study has now been performed 14 times on several continents by many investigators. The studies have shown that MMR doesn’t cause autism.

As several different investigations-summed up in a British Medical Journal (BMJ) editorial this month-have shown, not a single aspect of Dr. Wakefield’s notion of how MMR causes autism has proven correct. He wasn’t just wrong, he was spectacularly wrong. Moreover, some of the children in his report had developed symptoms of autism before they had received the vaccine-and others never actually had autism.

In addition, as journalist Brian Deer found, Dr. Wakefield received tens of thousands of pounds from a personal-injury lawyer in the midst of suing pharmaceutical companies over MMR. (After Mr. Deer’s discovery, Dr. Wakefield admitted to receiving the money.) Last year, when the Lancet found out about the money, it retracted his paper. But it was far too late.

Dr. Wakefield’s paper created a firestorm. Thousands of parents in the United Kingdom and Ireland chose not to vaccinate their children. Hundreds of children were hospitalized and four killed by measles. In 2008, for the first time in 14 years, measles was declared endemic in England and Wales.

Dr. Wakefield’s claim sparked a general distrust of vaccines. In recent years-as more parents chose not to vaccinate their children-epidemics of measles, mumps, bacterial meningitis and whooping cough swept across the United States. The whooping cough epidemic currently raging in California is larger than any since 1955.

Although it’s easy to blame Andrew Wakefield, he’s not the only one with dirty hands. The editor of the Lancet, Richard Horton, sent Dr. Wakefield’s paper to six reviewers, four of whom rejected it. That should have been enough to preclude publication. But Mr. Horton thought the paper was provocative and published it anyway.

Many others in the media showed similar poor judgment, proclaiming Dr. Wakefield’s paper an important study even though it was merely a report of eight children that, at best, raised an untested hypothesis.

Meanwhile, public-health officials and scientists were slow to explain in clear, emphatic terms that Dr. Wakefield’s hypothesis didn’t make a bit of sense.

Even today, important voices aren’t drawing the right conclusions. The BMJ, for example, wrote in its editorial that “clear evidence of falsification of data should now close the door on this damaging vaccine scare.” But it’s not Dr. Wakefield’s lapses that matter-it’s that his hypothesis was so wrong.

Even if Dr. Wakefield hadn’t been fraudulent, his hypothesis would have been no less incorrect or damaging. Indeed, by continuing to focus on Dr. Wakefield’s indiscretions rather than on the serious studies that have proved him wrong, we only elevate his status among antivaccine groups as a countercultural hero.

The American astronomer and astrophysicist Carl Sagan once wrote that, “Extraordinary claims should be backed by extraordinary evidence.” Dr. Wakefield made an extraordinary claim backed by scant evidence. Undoubtedly, bad science will continue to be submitted for publication. Next time, one can only hope that journal editors and the media will be far more circumspect.

Dr. Offit, the chief of infectious diseases at the Children’s Hospital of Philadelphia, is the author of “Deadly Choices: How the Anti-Vaccine Movement Threatens Us All” (Basic Books, 2011).

Discrediting a decade-long debate over autism and vaccines, the British Medical Journal (click here for link) published its findings proving Dr. Andrew Wakefield’s controversial study linking autism with the MMR vaccine was fraudulent. Backed by medical journalist Brian Deer‘s reporting (click here for link), the Journal cited the “clear evidence of falsification” in three of the paper’s conclusions:

1. Wakefield’s 1998 Lancet study misrepresented or altered the medical histories of all 12 of the patients, five of which showed developmental problems before receiving the MMR vaccine and three never had autism. In falsifying these records, BMJ found there was “no doubt” Wakefield was responsible.

2. No studies have been able to replicate the results Wakefield published. Wakefield himself has been asked to reproduce his results and has been unable to do so.

3. The BMJ reports that Wakefield received more than $674,000 from a law firm intending to sue vaccine manufacturers, a conflict of interest that was not disclosed in theLancet study.
For those who suspect Wakefield’s conclusions may simply be wrong and he did not intentionally falsify the data, the BMJ refuses to accept such a stance. “A great deal of thought and effort must have gone into drafting the paper to achieve the results [Wakefield] wanted: the discrepancies all led in one direction; misreporting was gross.” The Lancet retracted the study in 2004, and British medical authorities revoked Wakefield’s medical license last May, but as the BMJ notes, serious harm has been done. “The damage to public health continues, fuelled by unbalanced media reporting and an ineffective response from government, researchers, journals, and the medical profession… Hundreds of thousands of children in the UK are currently unprotected as a result of the scare, and the battle to restore parents’ trust in the vaccine is ongoing.”

Wakefield Fallout Prompts Discussion on True Causes of Autism

Media reports exploded this week following BMJ’s editorial on Wakefield’s fraudulent study. Cable and network affiliates as well as major print outlets covered the story. CNN’sAnderson Cooper devoted two nights of coverage to the issue, including an interview with Wakefield immediately following the breaking news. CBS Evening News with Katie Couric featured Dr. Paul Offit, head of Infectious Disease at Children’s Hospital of Philadelphia, and Katie van Tornhout, a mother whose one-month-old daughter (who was too young to be vaccinated) died of whooping cough last year after she contracted the illness likely from someone who was not immunized. As reporting continued, a growing focus turned to supporting scientific-based research on autism and its causes. Alison Singer, President and Co-founder of The Autism Science Foundation, appeared on CNN encouraging the public and medical community to “finally put the question of vaccines and autism behind us” and “invest in studies that will allow us to find out what does cause autism.”

Offit, Mnookin Challenge Anti-Vaccine Movement with Book Releases

As the news began to spread on Wakefield’s fraudulent study, Dr. Paul Offit was speaking to a group at The National Press Club in Washington, D.C. on the dangerous consequences of the anti-vaccine movement, which escalated following Wakefield’s controversial report. On that evening, Offit described his newest book, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, a comprehensive review of the outspoken voices against vaccines and how their unsubstantiated and false claims have lead to a generation of parents choosing to not vaccinate their children. As Shot of Prevention noted “standing before us was a man who demonstrated genuine compassion for children and who generously donates the proceeds of his book to autism research…outside of the room, journalists from most major news stations were busy putting Andrew Wakefield in the spotlight (once again), based on the immoral and fraudulent nature of his study that has had an overwhelming negative impact on the vaccination of children.”

On NPR’s Science Friday, Offit discussed the fatal implications such choices to delay vaccines would have on young children and society at large citing the recent California pertussis outbreak as an unfortunate, but preventable consequence of these decisions. In addition to Offit’s book, Vanity Fair contributor Seth Mnookin’s The Panic Virus: A True Story of Medicine, Science, and Fear comes out next Tuesday, and like Offit, Mnookin chronicles the early vaccine story, its players, and the emergence of vaccine opponents who have challenged public health experts and mobilized a vocal following in their search for answers to the proposed autism-vaccine link.

Timing really is everything. Last night, after a full day of talking to the media about the British Medical Journal story which deemed Wakefield’s original 1998 study an “elaborate fraud”, the Autism Science Foundation hosted a celebration launch of Dr. Paul Offit’s new book “Deadly Choices: How the Anti-Vaccine Movement Threatens Us All” with a reception and book signing at the National Press Club in Washington DC.

There were lots of members of the press there, many of whom we’d spoken with earlier in the day, as well as plenty of friends and family. There couldn’t have been a more appropriate time to talk about how the anti-vaccine movement has wreaked havoc with our public health system and how the erroneous conclusion that vaccines cause autism has put so many children’s lives at risk. Later this month we’ll host events in New York, Philadelphia and Boston.

If you haven’t read this book yet, we urge you to get a copy. All royalties are being donated to the Autism Science Foundation so that we can fund studies to uncover what really DOES cause autism. Our thanks to everyone who attended last night’s event and, as always, enormous thanks to Dr. Offit and his family for his unwavering dedication to children’s health.